Website Tennessee Cancer Specialists
If you are motivated and have excellent interpersonal effectiveness then apply for the Pre-Certification Specialist offered by the Tennessee Cancer Specialists. They are offering new job opportunities in their Knoxville, TN 37915 offices. Application deadline is approaching, apply soon.
Job: Pre-Certification Specialist
Company: Tennessee Cancer Specialists
Location: Knoxville, TN 37915
Tennessee Cancer Specialists is seeking a full-time, Pre-Certification Specialist who will support our Knoxville, TN and surrounding area locations out of our downtown Knoxville Central Billing Office.
Why work for Tennessee Cancer Specialists?
Patients, family members and caregivers often ask if you have to have special training to be part of our team because they notice that we enjoy our work and serve with respect, dignity and empathy. We truly work as a team and care about each other, which creates better outcomes and a better environment for our patients. Our culture recognizes the contribution of each team member and the importance of giving our patients hope through having a positive and upbeat attitude. We know that what we do matters and, therefore, attract people who want to apply their experience, skills and education in ways that make a meaningful and lasting difference in the lives of our patients and families.
At Tennessee Cancer Specialists, it is our privilege to walk with our patients and their families as they move along the journey of fighting cancer. Whether you are working in the clinic directly with patients or in administration providing support, you are an important part of making our mission to deliver the highest quality, compassionate care come true.
What We Have to Offer:
We value our employees and offer a competitive benefits package that includes medical, dental, vision, and life insurance; paid time off; paid holidays; short- and long-term disability; flexible spending accounts; AFLAC; 401(k) and profit sharing.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Reviews, processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence
Communicates with nursing and medical staff to inform them of any restrictions or special requirements in accordance with particular insurance plans
Provides prompt feedback to physicians and management regarding pathway documentation issues and payor issues with non-covered chemotherapy drugs
Updates coding/payor guidelines for clinical staff
Tracks pathways and performs various other business office functions on an as needed basis
Obtains insurance authorization and pre-certification specifically for chemotherapy services
Works as a patient advocate and functions as a liaison between the patient and payor to answer reimbursement questions and avoid insurance delays
Researches additional or alternative resources for non-covered chemotherapy services to prevent payment denials
Provides a contact list for patient community resources, including special programs, drugs and pharmaceutical supplies, and financial resources
Maintains a good working knowledge of chemotherapy authorization requirements for all payors and state and federal regulatory guidelines for coverage and authorization
Performs other duties as requested or assigned
High school diploma or equivalent required
Associates degree in Healthcare, LPN state license and registration preferred
Oncology knowledge highly preferred
Minimum one (1) year medical insurance verification and authorization and one (1) year pre-certification experience required
EOE/M/F/D/V/SO. We are a Drug-free Workplace.
To apply for this job please visit workforcenow.adp.com.